Article Text

other Versions

Clinical subsequent fractures cluster in time after first fractures
  1. Tineke ACM van Geel (t.vangeel{at}
  1. Maastricht University, Netherlands
    1. Svenhjalmar van Helden (s.vanhelden{at}
    1. Maastricht University Medical Centre, Netherlands
      1. Piet P Geusens (piet.geusens{at}
      1. Maastricht University Medical Centre, Netherlands
        1. Bjorn Winkens (bjorn.winkens{at}
        1. Maastricht University, Netherlands
          1. Geert-Jan Dinant (geertjan.dinant{at}
          1. Maastricht University, Netherlands


            Objectives: The risk of subsequent fractures is double the risk of having a first fracture. We analysed whether this risk is constant or not over time.

            Methods: A population-based study in 4140 postmenopausal women, aged between 50 and 90 years, on radiographic confirmed clinical fractures from menopause onwards analysed by Cox regression.

            Results: 924 (22%) women had a first fracture and 234 (26% of 924) a subsequent fracture. Four percent of all first fractures occurred in each year from menopause onwards, while after a first fracture, 23% of all subsequent fractures occurred within one year and 54% within five years. When calculated from time of a first fracture, the relative risk (RR) of subsequent fracture was 2.1 (95% confidence interval (CI): 1.7-2.6) and remained increased during 15 years. When calculated for specific time intervals after a first fracture, the RR was 5.3 (CI: 4.0-6.6) within one year, 2.8 (CI: 2.0-3.6) within 2-5 years, 1.4 (1.0-1.8) within 6-10 years and 0.41 (CI: 0.29 -0.53) after >10 years.

            Conclusions: From menopause onwards, clinical fractures cluster in time indicating the need for early action to prevent subsequent fractures.

            Statistics from

            Request permissions

            If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.